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'Monofixational exotropia' may better describe patients with constant microtropia
Am J Ophthalmol. 2009;147(6):1082-1085.
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Many patients who underwent surgery for presumed intermittent exotropia had preoperative constant microtropia, according to a study.
"The presence of monofixation syndrome after surgery for presumed intermittent exotropia most likely reflects the fact that it was present preoperatively," the study author said. "Many of these patients manifest a constant microtropia preoperatively and hence should not be called intermittent exotropes. The term monofixational exotropia is more appropriately descriptive."
The retrospective study included data from two previously published clinical trials on the treatment of intermittent exotropia with a focus on the occurrence of monofixation syndrome.
The data included 215 patients who underwent surgery for presumed intermittent exotropia. The primary outcome measure was the presence of postoperative monofixation.
Of the 215 patients who underwent surgery, 194 were older than 3 years, had bifoveal fusion and did not present with preoperative manifest microtropia. No patients in this group developed monofixation syndrome postop.
Fourteen patients who had been excluded from previous studies because they were too young for sensory testing were also included. Seven of those 14 patients had monofixation syndrome after surgery. Another seven patients who had been excluded from the previous studies because of constant microtropia before surgery were included and had monofixation syndrome after surgery, the author said.